It's easier – and cheaper – to retain good employees than to recruit them. While that simple premise is acknowledged as truth in management circles, the reality of worker retention in the medical environment is far from simple.

 

The stress-filled life of front-line hospital providers, from technicians to nurses and physicians, means inevitable burnout and frustration. It's up to hospital administrators to "cut through a lot of the headaches," said Chuck Wainwright, Belmont University associate professor of management. Wainwright joined Belmont's College of Business Administration a year ago with a master's in health administration, a doctorate in health-services strategic management and years with the U.S. Army Medical Department under his belt.

 

"Taking the temperature of the organization on a regular basis shows that you care," Wainwright said. He encouraged hospital administrators to seek out employees' feedback and embrace their suggestions, even if they come in the form of criticism. Criticism is borne of frustration, and curtailing employee frustration is the administration's job, he said.

 

Administrators would do well to take their cues from the Lean Healthcare movement, adapted from the Toyota Production System, Wainwright suggested. The continuous-improvement program approaches healthcare inefficiency from a variety of angles – workflow, patient flow, scheduling, equipment availability, emergency room throughput, human resources and hiring, just to name a few – and offers techniques to eliminate cumbersome activities that impede productivity. One reason for employee dissatisfaction is if employees feel they aren't as productive as they could be, if they feel they are spinning their wheels, he said.

 

Another tenet of Lean Healthcare is boosting the best employees and eliminating the worst ones. Ridding the hospital roster of dead weight isn't an easy proposition, but failing to do so rewards poor performance and places more responsibility on the shoulders of good performers. "Employees talk. They know who the slackers are and who's not, and they resent bosses who don't take the initiative," Wainwright said. "The good people are going to leave. The bad people are going to stay, because they think they've got a great deal."

 

Lean Healthcare also encourages mentoring at all levels, particularly early in an employee's tenure, and that includes physicians. "Healthcare does a poor job of orientation," Wainwright said. "We are good at usually giving people the rules – the do's and don'ts – but we don't tell them about the culture, and we don't make them feel as welcome as we could."

 

Wainwright said hospitals could learn a few things from the U.S. Army, too. Ensuring that employees are continually being trained in the latest techniques and theories is a key to employee fulfillment – and in medicine, it's critical for patient care. "I'd say at least half my time in the military, I was doing something with training and education. … That's a big benefit," he said. The military also rotates people around the organization where possible, giving employees new challenges and a fresh outlook.

 

Other employee-retention strategies suggested by Wainwright included: